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Are Amber Teething Necklaces Dangerous?

There has been lots of discussion as to whether amber teething necklaces work, and whether they pose a risk to your child.

These questions may be deeply intertwined, as those who think amber teething necklaces are too risky often believe they don’t work, while those that use them despite any risks, usually swear by their teething pain nullifying ability.

In this post we’ll discuss the actual risks, and also how to use these teething necklaces safely.

What are amber teething necklaces? Do they work?

An amber teething necklace is a small necklace made out of natural amber. Amber is fossilized tree resin and is millions of years old. There’s not much scientific data available to support or refute the claim that amber teething necklaces work, but many parents swear by them.

Succinic acid, which is in Baltic amber at up to 8% concentration, is thought to act as an analgesic when absorbed through baby’s skin. There’s no evidence that succinic acid does, indeed, pass into the body in this way, but there is some information that succinic acid may have a soothing effect. Succinic acid is actually the precursor to aspirin so it would make sense that it could have soothing effects. One study found that succinic acid helped reduce stress induced hyperthermia (a rise in temperature) in mice. When babies are teething they feel pain and may have a slight temperature associated with this pain and stress. It would make sense then, that succinic acid may help reduce this discomfort.

Is succinic acid safe?

Succinic acid is a naturally occurring compound present in many animals, plants, and microorganisms. Succinic acid has been tested and deemed safe by the U.S. Food and Drug Administration (FDA) as a food additive. They state:

‘There is no evidence in the available information on succinic acid that demonstrates, or suggests reasonable ground to suspect, a hazard to the public when it is used at levels that are now current or that might reasonably be expected in the future.”

What makes amber teething necklaces dangerous?

There are several risks associated with teething necklaces, and they have nothing to do with the naturally occurring succinic acid.

Risk #1: Strangulation

The obvious danger with anything that goes around a small child’s neck is strangulation. Tragically, one child, Deacon Morin died from strangulation while wearing an amber teething necklace during a nap at daycare. Whether the necklace was the cause of strangulation is still up for debate, as the child’s mother, Dani Elaine, stated on Facebook:

[The daycare is] trying to hide their lack of supervision by stating that Deacon choked on his Amber necklace. This is not the case, and his medical examinations have shown another story… Whether or not his beads were involved is still under investigation.

Another child, Ellie, was injured when she got her arm through the necklace and twisted it into a figure eight during her nap.

These incidents both occurred during naptime, a time which the teething necklaces are not intended to be used. Children wearing amber teething necklaces should never be left unattended and should never wear the jewelry while sleeping or napping. This is a critical safety measure that many parents don’t follow.

A possible reason why many parents allow teething necklaces to stay on 24/7 is that many babies are fussiest at sleep times. Understandably, parents want to provide natural teething pain relief at those times if possible. Some parents remove the necklace from the child’s neck and wrap it around a wrist or ankle to lessen the risk of strangulation while still providing some pain relief. However, Mama Natural warns against this practice.

Mama Natural’s strong recommendation is to remove the necklace completely while the child is sleeping or is unsupervised, even if that’s only for a very short period of time. Better safe than sorry.

Risk #2: Break away feature not working

Teething necklaces are supposedly designed to break away easily as a safeguard from strangulation. But one Canadian study showed that almost 50% of the necklaces tested didn’t breakaway with 15 pounds of pressure (the standard amount of pressure used to test children’s jewelry).

The other possible danger of teething necklaces is that when they do break, baby may ingest or inhale the beads. Most teething necklaces are made with a knot between each bead so that, if the necklace breaks, the beads don’t scatter. Instead, just one bead will fall off of the necklace, lessening the choking risk.

Risk #3: Length

When we look back at the story of Ellie, who got an arm through her necklace while it was still around her neck, the necklace that she wore was likely too long for her.

It’s important to buy a well fitting amber teething necklace for this reason. You should be able to fit two fingers between the necklace and your child’s neck while your child is wearing it, but the necklace should not be long enough for the child to bring the beads up to his or her mouth.

As a general rule:

11″ amber teething necklaces are appropriate for children up to one year of age

13″ amber teething necklaces are sized well for children from 1-6 years old

Again, choose a necklace that is short enough that a child cannot get the necklace into his mouth, but long enough so that it’s comfortable.

Safe use and alternatives

Ireland’s Health Service Executive (HSE) warns very strongly against the use of amber teething necklaces. The reasons are the same as the potential risks we’ve talked about here and they add that:

“Suppliers and retailers are warned that the Competition and Consumer Protection Commission considers these products inherently unsafe and will take appropriate action to remove these products from sale.”

What’s interesting to note is that further down the page, the HSE recommends numbing gels like ones containing benzocaine instead. The FDA has warned that benzocaine can sometimes cause a rare but dangerous condition called methemoglobinemia, in which the oxygen in the blood stream becomes dangerously low. Symptoms include pale skin and lips, fatigue, confusion, headache and elevated heart rate. This study documents at least 2 cases of this happening.

The American Academy of pediatrics (AAP) doesn’t recommend using Benzocaine, but they do recommend using acetaminophen (Tylenol), which the AAP themselves have found to be potentially dangerous, especially for children. Acetaminophen is the number one cause of acute liver failure in children.

So what’s a mama to do?

Of course other teething remedies like rubber teething rings are an option, but when things are intense and you need something that will really work, you may decide to try an amber teething necklace.

Amber teething necklaces are not inherently dangerous (at least not more so than benzocaine or acetaminophen); it’s user-error that can cause a potentially dangerous and tragic situation.

If you choose to use these necklaces for your teething infant or toddler, always adhere to these safety measures (approved by the AAP):

Never leave your child unattended while wearing jewelry.

Never allow your child to sleep while wearing a necklace around his or her neck.

Be sure that the necklace you’ve purchased is the right length.

It should not be loose enough to get to your child’s mouth.

It should be loose enough to be comfortable though.

Choose a necklace that is knotted between each bead to avoid scattering beads.

Accidents do happen and can cause incredible tragedies for families. According to the Center for Disease Control (CDC) over 3,000 children die each year from accidental drownings not related to boating.

In comparison, we only know of one death that may be linked to a teething necklace, and the safety precautions weren’t being followed. None of these tragic deaths are taken lightly, and even one death is too many, but we do need to take into consideration the relative risk.

Some parents feel that the risk, no matter how small, isn’t worth testing, especially if they don’t feel confident they can follow the safety guidelines every time (like taking the necklace off at bedtime).

Other parents may, instead, see that the risks are directly related to not following safety precautions, like leaving baby unattended or allowing baby to sleep while wearing the necklace; these parents may feel confident that they can follow those precautions every time.

Bottom line

Some parents swear by the efficacy of amber teething necklaces, while others aren’t sure if they work at all. The potential risk must be considered with efficacy in mind. If an amber teething necklace doesn’t work for your child, there’s no reason to use it.

However, if you have seen positive results in your teething baby or toddler while wearing the necklace, you may decide to continue to use the necklace. If you do use these necklaces, be sure to follow the safety guidelines provided by the AAP and our team here at Mama Natural.

How about you?

Have you used amber teething necklaces? What steps do you take to ensure your child’s safety while wearing one? Share with us in the comments below.